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<meta name="DC.Title" content="First-Line Use of Core Needle Biopsy for High-Yield Preliminary Diagnosis of Thyroid Nodules" />
<meta name="DC.Identifier" content="10.3174/ajnr.A5007" />
<meta name="DC.Date" content="2017-02-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2017 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Although core needle biopsy was introduced as a diagnostic alternative to fine-needle aspiration, the utility and safety of core needle biopsy for thyroid nodules in a large population has yet to be studied comprehensively. We evaluate core needle biopsy yields on a large-scale basis to investigate its potential in the preliminary diagnosis of thyroid nodules.

MATERIALS AND METHODS: Between March 2005 and December 2013, 2448 initially detected thyroid nodules from 2120 consecutive patients who underwent core needle biopsy were retrospectively evaluated. Of these, 72 thyroid nodules from 63 patients were excluded due to prior fine-needle aspiration attempts. The inconclusive and conclusive result rates, diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and unnecessary surgery rate of core needle biopsy were evaluated.

RESULTS: With core needle biopsy as the first-line method, the inconclusive result rate was 11.9% (283/2376) and the conclusive result rate was 88.1% (2093/2376). The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of core needle biopsy for the diagnosis of malignancy were 96.7% (1160/1200), 89.7% (347/387), 100% (813/813), 100% (347/347), and 95.3% (813/853), respectively. There were no major complications and 12 minor complications.

CONCLUSIONS: We have demonstrated that first-line use of core needle biopsy may well improve diagnostic accuracy in thyroid nodules, reducing inconclusive or false-negative results and unnecessary operations. Such benefits underscore the promising role of core needle biopsy in managing thyroid nodules and optimizing related surgical decision-making.

AUS
:   atypia of undetermined significance
CNB
:   core needle biopsy
FLUS
:   follicular lesion of undetermined significance
FNA
:   fine-needle aspiration
NPV
:   negative predictive value
PPV
:   positive predictive value
US
:   ultrasonography" />
<meta name="DC.Contributor" content="H.C. Kim" />
<meta name="DC.Contributor" content="Y.J. Kim" />
<meta name="DC.Contributor" content="H.Y. Han" />
<meta name="DC.Contributor" content="J.M. Yi" />
<meta name="DC.Contributor" content="J.H. Baek" />
<meta name="DC.Contributor" content="S.Y. Park" />
<meta name="DC.Contributor" content="J.Y. Seo" />
<meta name="DC.Contributor" content="K.W. Kim" />
<meta name="article:published_time" content="2017-02-01" />
<meta name="article:section" content="HEAD &amp;amp; NECK" />
<meta name="citation_title" content="First-Line Use of Core Needle Biopsy for High-Yield Preliminary Diagnosis of Thyroid Nodules" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Although core needle biopsy was introduced as a diagnostic alternative to fine-needle aspiration, the utility and safety of core needle biopsy for thyroid nodules in a large population has yet to be studied comprehensively. We evaluate core needle biopsy yields on a large-scale basis to investigate its potential in the preliminary diagnosis of thyroid nodules.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Between March 2005 and December 2013, 2448 initially detected thyroid nodules from 2120 consecutive patients who underwent core needle biopsy were retrospectively evaluated. Of these, 72 thyroid nodules from 63 patients were excluded due to prior fine-needle aspiration attempts. The inconclusive and conclusive result rates, diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and unnecessary surgery rate of core needle biopsy were evaluated.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;With core needle biopsy as the first-line method, the inconclusive result rate was 11.9% (283/2376) and the conclusive result rate was 88.1% (2093/2376). The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of core needle biopsy for the diagnosis of malignancy were 96.7% (1160/1200), 89.7% (347/387), 100% (813/813), 100% (347/347), and 95.3% (813/853), respectively. There were no major complications and 12 minor complications.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;We have demonstrated that first-line use of core needle biopsy may well improve diagnostic accuracy in thyroid nodules, reducing inconclusive or false-negative results and unnecessary operations. Such benefits underscore the promising role of core needle biopsy in managing thyroid nodules and optimizing related surgical decision-making.&lt;/p&gt;" />
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<meta name="twitter:title" content="First-Line Use of Core Needle Biopsy for High-Yield Preliminary Diagnosis of Thyroid Nodules" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Although core needle biopsy was introduced as a diagnostic alternative to fine-needle aspiration, the utility and safety of core needle biopsy for thyroid nodules in a large population has yet to be studied comprehensively. We evaluate core needle biopsy yields on a large-scale basis to investigate its potential in the preliminary diagnosis of thyroid nodules.

MATERIALS AND METHODS: Between March 2005 and December 2013, 2448 initially detected thyroid nodules from 2120 consecutive patients who underwent core needle biopsy were retrospectively evaluated. Of these, 72 thyroid nodules from 63 patients were excluded due to prior fine-needle aspiration attempts. The inconclusive and conclusive result rates, diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and unnecessary surgery rate of core needle biopsy were evaluated.

RESULTS: With core needle biopsy as the first-line method, the inconclusive result rate was 11.9% (283/2376) and the conclusive result rate was 88.1% (2093/2376). The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of core needle biopsy for the diagnosis of malignancy were 96.7% (1160/1200), 89.7% (347/387), 100% (813/813), 100% (347/347), and 95.3% (813/853), respectively. There were no major complications and 12 minor complications.

CONCLUSIONS: We have demonstrated that first-line use of core needle biopsy may well improve diagnostic accuracy in thyroid nodules, reducing inconclusive or false-negative results and unnecessary operations. Such benefits underscore the promising role of core needle biopsy in managing thyroid nodules and optimizing related surgical decision-making.

AUS
:   atypia of undetermined significance
CNB
:   core needle biopsy
FLUS
:   follicular lesion of undetermined significance
FNA
:   fine-needle aspiration
NPV
:   negative predictive value
PPV
:   positive predictive value
US
:   ultrasonography" />
<meta name="og-title" property="og:title" content="First-Line Use of Core Needle Biopsy for High-Yield Preliminary Diagnosis of Thyroid Nodules" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/38/2/357" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Although core needle biopsy was introduced as a diagnostic alternative to fine-needle aspiration, the utility and safety of core needle biopsy for thyroid nodules in a large population has yet to be studied comprehensively. We evaluate core needle biopsy yields on a large-scale basis to investigate its potential in the preliminary diagnosis of thyroid nodules.

MATERIALS AND METHODS: Between March 2005 and December 2013, 2448 initially detected thyroid nodules from 2120 consecutive patients who underwent core needle biopsy were retrospectively evaluated. Of these, 72 thyroid nodules from 63 patients were excluded due to prior fine-needle aspiration attempts. The inconclusive and conclusive result rates, diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and unnecessary surgery rate of core needle biopsy were evaluated.

RESULTS: With core needle biopsy as the first-line method, the inconclusive result rate was 11.9% (283/2376) and the conclusive result rate was 88.1% (2093/2376). The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of core needle biopsy for the diagnosis of malignancy were 96.7% (1160/1200), 89.7% (347/387), 100% (813/813), 100% (347/347), and 95.3% (813/853), respectively. There were no major complications and 12 minor complications.

CONCLUSIONS: We have demonstrated that first-line use of core needle biopsy may well improve diagnostic accuracy in thyroid nodules, reducing inconclusive or false-negative results and unnecessary operations. Such benefits underscore the promising role of core needle biopsy in managing thyroid nodules and optimizing related surgical decision-making.

AUS
:   atypia of undetermined significance
CNB
:   core needle biopsy
FLUS
:   follicular lesion of undetermined significance
FNA
:   fine-needle aspiration
NPV
:   negative predictive value
PPV
:   positive predictive value
US
:   ultrasonography" />
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      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">HEAD &amp; NECK</span></span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">First-Line Use of Core Needle Biopsy for High-Yield Preliminary Diagnosis of Thyroid Nodules</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">H.C. Kim</span>, <span class="highwire-citation-author" data-delta="1">Y.J. Kim</span>, <span class="highwire-citation-author" data-delta="2">H.Y. Han</span>, <span class="highwire-citation-author" data-delta="3">J.M. Yi</span>, <span class="highwire-citation-author" data-delta="4">J.H. Baek</span>, <span class="highwire-citation-author" data-delta="5">S.Y. Park</span>, <span class="highwire-citation-author" data-delta="6">J.Y. Seo</span> and <span class="highwire-citation-author" data-delta="7">K.W. Kim</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">February 2017,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">38 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">357-363; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A5007 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-14641--61290354302" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">H.C. Kim </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology (H.C.K., Y.J.K., J.Y.S., K.W.K.), Konyang University Myunggok Medical Research Institute, Konyang Hospital, Konyang University College of Medicine, Daejeon, Republic of Korea</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=H.C.%2BKim%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kim%20H&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AH.C.%2BKim%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-1319-281X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for H.C. Kim</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">Y.J. Kim </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology (H.C.K., Y.J.K., J.Y.S., K.W.K.), Konyang University Myunggok Medical Research Institute, Konyang Hospital, Konyang University College of Medicine, Daejeon, Republic of Korea</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Y.J.%2BKim%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kim%20Y&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AY.J.%2BKim%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-7084-0289" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Y.J. Kim</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">H.Y. Han </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Radiology (H.Y.H., J.M.Y.), Daejeon Sun Hospital, Daejeon, Republic of Korea</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=H.Y.%2BHan%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Han%20H&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AH.Y.%2BHan%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-1316-8841" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for H.Y. Han</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">J.M. Yi </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Radiology (H.Y.H., J.M.Y.), Daejeon Sun Hospital, Daejeon, Republic of Korea</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.M.%2BYi%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Yi%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.M.%2BYi%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-5189-7351" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J.M. Yi</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">J.H. Baek </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Radiology and Research Institute of Radiology (J.H.B.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.H.%2BBaek%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Baek%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.H.%2BBaek%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-0480-4754" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J.H. Baek</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">S.Y. Park </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of Pathology (S.Y.P.), Konyang University Hospital, Konyang University College of Medicine, Daejeon, Republic of Korea</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.Y.%2BPark%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Park%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AS.Y.%2BPark%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-0072-5613" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S.Y. Park</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">J.Y. Seo </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology (H.C.K., Y.J.K., J.Y.S., K.W.K.), Konyang University Myunggok Medical Research Institute, Konyang Hospital, Konyang University College of Medicine, Daejeon, Republic of Korea</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.Y.%2BSeo%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Seo%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.Y.%2BSeo%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-5354-6208" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J.Y. Seo</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">K.W. Kim </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology (H.C.K., Y.J.K., J.Y.S., K.W.K.), Konyang University Myunggok Medical Research Institute, Konyang Hospital, Konyang University College of Medicine, Daejeon, Republic of Korea</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=K.W.%2BKim%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kim%20K&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AK.W.%2BKim%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-7312-5483" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for K.W. 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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 38</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 2 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Feb 2017 </div></div>
      
      
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      <div class="highwire-cite-title">First-Line Use of Core Needle Biopsy for High-Yield Preliminary Diagnosis of Thyroid Nodules</div>  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Feb 2017, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">38 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">357-363; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5007 </span></div>
  
  
  
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      <div class="highwire-cite-title">First-Line Use of Core Needle Biopsy for High-Yield Preliminary Diagnosis of Thyroid Nodules</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">H.C.</span> <span class="nlm-surname">Kim</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Y.J.</span> <span class="nlm-surname">Kim</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">H.Y.</span> <span class="nlm-surname">Han</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">J.M.</span> <span class="nlm-surname">Yi</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">J.H.</span> <span class="nlm-surname">Baek</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">S.Y.</span> <span class="nlm-surname">Park</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">J.Y.</span> <span class="nlm-surname">Seo</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">K.W.</span> <span class="nlm-surname">Kim</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Feb 2017, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">38 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">357-363; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5007 </span></div>
  
  
  
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